WQ0041321_Regional Office Historical File Pre 2018

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to 17)e corriploed by DWR
All items must be completed or the application NN ill be returned
I. .APPLICANT INFORMATION:
I, Applicant's .name: Rosser Holdings (company, municipality, HOA.; uiIitv,etc,)
2. Applicant type: Individual Z Corporation General Partnership E Privately -Owned Public Utility
[2] Federal Stae Count Municpal D Other
3. Signature authority's name: Robert Rosser per .15A N(1%,\ C 021 ,(006.th)
Title: President
4. Applicant's mailing address: 6100 Mooresville Rd
City: Kannapolis State: NC ,Zip: 28081.-
5, Applicant's contact information:
Phone number: [phone] Email Address: bob6:41structione.ers,,net
11. PROJECT INFORMATION:
I. Project name: Grace Manor
Application/Project status:
Z Proposed (New Perri
Ilia modification, provide the existing permit number: WQ00
LI Existing Pcrniit Piocct
and issued date'
11'nm construction but part of a master plan, provide the existing permit number: WQ00
3, County Nvh ere project is located: Cabarrus
4, Approximate Coordinates (Decimal Degrees): I..,atitude: 35,4636Longitude: -80,6665'
5, Parcel ID (if applicable): 5602.-37-6300
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
Professional Engineer: John C. Darden, IIILicense Number; 38583,
Firm: Darden Engineering Services PLIC
Mailing address: 107.„CaywDrivQ
(. ity:Mooresville State: NC Zip; 28117
Phone number: [phone]
Email Address: john3(ii)dardeneng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Rocky River Regional Wastewater Treatment Plant Permit Number: NC0036269
Owner Name: 'Water & Sewer Authority of Cabarrus County
V. RECEIVING 'DOWNSTREAM SEWER, INFORMATION (if different than WWTF):
I, Permit Number( : Wc),_
Downstream (Receiving.) Sewer Size: inch
System Wide Collection Sy5tem .Pcnnit NL.unber(j WQCS
Owner Namets):
FORM: FT,,A 04-16 Page 1 of 5

GENERAL REQUIREMENTS
1. If the Applicant is. a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
Yes No ZNIA
if the Applicant is a Developer of lots to be sold, has a Develpper's Operational ;A ci mt FORM: DEVI been attached?'
LI Yes JNo N/A
3. If the Applicantis a Home/Pro e s' Association has an Operational Agreement' (FORM: HOAj been attached?
Li Yes • N/A
4. Origin of wastewater: (check all that apply):
El Residential Owned
El Residential Leased
El School preschool day care
Food and drink facilities
El Businesses / offices / factories
11 Retail (stores, centers, malls)
' 'Retail with. food preparation/service.
Medical / dental veterinary facilities
[1 Church
Nursing, Home
5. Nature of wastewater % Domestic/Commercial 100 % Commercial
% Industrial (See l5A NCAC 02T .01(4(201)
)-Is there a Pretreatment Program in effect?
6. Has a flow reduction been approved under 15A NCAC 02T 01 14tTi? El Yes No
If yes, provide a copy of flow reduction approval letter
Summarize wastewater generated by project:
Establishment Type (see )2.T.0114(fl)
Wedd in g 'venue
Daily Design Flow "
30 gallday (per seat)
gal
gal
gal
El Car Wash
Hotel and or Motels
Lj Swimming Pool /Clubhouse
L Swimming Pool/Filter .Backwash
E Other (Explain in Attachment)
17820 GPD
gal
GPD
GPD
GPD
CIPD
GPD
Total 17820 GPD
a See 15A NCAC 021- ,0 I 4( b (d),_(e) 72". 'for caveats to wastewater design flow rates ij, ... minimum flow per
dwelling, proposed unknown non-residential development uses, public access facilities located near high public use areas:
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in. 1) S,
b Per I 5A NCAC 02T .0114(c), design flow rates for establishments not identified tin table 1.5A NC.AC 021-.0114.1 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data,
8, Wastewater generated by project: 1 7820 GPD (per jJ,5A NCAC 021 .01(4)
Do not include future flows or previously permitted allocations
If permitted Clow is zero, indicate why,
El Pump Station or Gravity' Sewer where flow will be permitted. in subsequent permits that connect to this Irne
Ei Flow has already been allocated in Permit Number:
El Rehabilitation or replacement of existing sewer with no new flow expected
El Other (Explaint:
FORM: FTA 04-16 Page 2 of 5

GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & i1DC (Gravity Sewers):
t. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet) Material
Section I1 & II1 of the MDC for Permitting of Gravity Sewers contains information related to design criteri
Section 111 contains info related to minimum
Oversizing Tines to meet mininttt slope requiremethin of the MDC
PUMP STATION DESIGN CRITERIA (1f Applicable) — 02T .0305 & MDC (Pump 1 +tations/Force M.ains):
COMPLETE FOR EACH PIMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: `1'he. Grand at Grace Manor
Approximate Coordinates (Decimal Degrees): Latitude: 35 `` Longitude:
3 Design flow of'the pump station: 0.04455 millions gallons per day (tarn capacity))
4. Operational point(s) of the pumps), 35 gallons per minute at 2,2 feet total dynamic head i.`I'DH )
S, Summarize the force main to he permitted (for this Pump Station):
Size (inches) Length (feet)
Material
443 PVC
r reliahi➢itv in accordance with
Statndby power source or pump with automatic activation and telemetry - .I5A NCAC 02T .0305(h)(1)(B)
Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Must be permanent to facility
Or if the pump station has an average daily flow less than 13,000 gallons per day:
Powe
Portable power source ‘viith manual activ
,0305(h)(I)(C)
or
quick -connection receptacle and telentetrs - ISA NCAC 02T
❑ Portable pumping emit with plugged emergency pump connection and telemetry - 1SA NCAC 02T _0305(h)(I)(C)�
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
If the portable power source or pump is dedicated to multiple ptunp stations, an evaivation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timefratnes, shall be provided
in the case of a multiple station power outage.
FORM: PTA 04-1.6
Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02 .0200 & 1.5A NCAC 02T ,0305(0):
1, Does the project comply with alt. separations found in 15,A 'NCAC 0T .0„30511) & (g)
15A NCAC 02T0305(fl_contams minimum separations that shall be provided for
Setback Parameter*
Storm sewers and other utilities not listed below(vertical)
Water mains '.vertical -water over sewer inch. in benched trenches
Water mains (11 -izontal)
—r systems:
Z Yes LINo
24 inches
18 inches
feet
Reciaimed water lines 've 'cal reclaimed over sewer)
Reclaimed ‘vtiter lines (horizontal - reclaimed over sewer)
Any private or public water supply source, including any wells, WS-I waters ol'Class
Class 11 impounded reservoirs used as, a source of drinking water 100 feet
**Waters classified WS (except WS-I or WS-V), B. SA, OR\, VIQW, or SB from normal
ngh water (or nde elevation) and wetlands (see item 1X.2) 50 feet
- • Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches 10 feet
18 inches
2 feet
An v building foundation
Anv basement
1 op slope of embankmen
5 feet
10 feet
s of 2 feet or more ertical heiht
rainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical.)
10 feet
5 feet
10 feet
36 inches
15A NC,\C 021-.0305(g1 contains alternatives where separations in 1)2 0 05 0 cannot. be achieved,
**Stream classifications can be identified using the Division's \( Surface Water Classifications wchpage
If noncompliance .with 1)y1'.03o5(fr or (11,j, see Section X of this application
2. Does the project comply with separation. requirements for wetlands? (50 feet at' separation) Yes
See the Division's draft separation requirements for situations where separation cannot be meet
No variance is required if the alternative design. criteria specified is utilized in design and construction
‘s built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A. NCAC 02B .0200?
This would include Trout Buffered Streams per 15A NC./AC .28..0202
4. Does the project require coverage/authorization under a 404 'Nationwide or
individual permits or 401 Water Quality Certifications?
Intiirmation can be obtained. •from the 401 & Buffer Perrniiiing Branch
Lil Yes
NA
5, Does project comply with 15A NCAC 02-1-.0105icKf (additional permitsleertifications)? Z Yes E No
Per 15,A N(1,1AC 021-.0105(.0(6),, directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
Does this project include any se er col lection lines that are deemed "high-priorityr
Per 15AN(1:zs:Si2,IA:)4±2, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, slpllofl. Or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
El 'Yes No ENA
1e 'Byes. include an attachment with details for each line, including type (ae 'al line, size, material, and Iocatton)
High priority lines shall be inspected by the perrnittee or its representative at least once every sis-months and inspections
documented per 1.5.A NCAC 02E0403(05) or the permi.tee's individual System -Wide Collection penult.
FORM 1TA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with J5,5NsT:m 07211, the Minimum Desigu Criteria fOr the Permitting of Pump ;`Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Desien Criteria (kitest version) as applicable?
Yes El No
IINo, complete and submit the Variance/Alternative Design Request application ( VADC 10-14) and supporting documents :for
review, Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
Jo/el i2'r4'e,i —Hr attest that this application for
(Professional Engineer's name from .Application Item 'ILL)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supposing documentation to die best of my knowledge, l further attest that to the best
of My knowledge the proposed design has teen prepared in accordance with the applicable regulations, Gravity Sewer
Miniamm Design Criteria for Gravity Sewers (latest version), and the Mimum Dcsign Criteria for the Fast Track Permitting
of Pump Stations and Force Mains (it -nest version). Although other ,i-(„fe.,siontils may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the propos ],t1 design,
NOTE In accordance with Creneral Statutes 143-21,5.6A and 14,.-215.6B, any person who knowingly makes any false
statement, representation, or certification in '&i.y application packagshall be guilty of a Class 2 misdemeanor, which may
include a tine not to exceed $10,000, as Well a', civil penalties up to 525.000 per violation,
k ,
' 1.0
North Carolina Professional Engineer's sea . signature, and date:
3, Applicant's Certification per 15A, N. 021 i 06(b):
K-asj'e5'/L
(Signature Authority's name & title from, App1icati
31
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge, 1 understand that if all required parts of
this application are 110i completed and that if all required supportin4 documentation and attachments are not included, this
application package is subject to being returnel as incomplete, I um,erstand that any discharge of wastewater from this non -
discharge system to surface waters or the land 'Lill result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. will make no claim ag-.tinst the Division of Water Resources should a condition
of this permit be violated. I also understand. if 3t if all required parts Jf this application package are not completed and that if
all required supporting information and attac'iments are not includ d, this application package will be returned to me as
incomplete.
NOTE — In accordance \vith Genetal Statute ; 143-215.6A and 143-215.6B, any person 'who knowingly makes any false
statement, representation, or certification in any application pa,,2!,,,ige s'itztll be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S!0,000 a well as civil penalties up to ".15,000 per violation,
Signature,
Date:
FORM: FTA 04-16 Page 5 of 5

WNALL
October 3, 2019
Mr, Michael Legg
City Manager
City of Kannapolis
401 Laureate Way
Kannapolis., NC 28081
Subject: Flow Acceptance Request — City of Kannapolis
Grace Manor Private Sanitary Sewer Extension
Dear Mr. Legg:
WATER & SEWER AUTHORM
OF CABARRUS COUNTY
232 Davidson Hwy.
Concord, NC 28027
704.786.1783 • 704.795.1564 Fax
www.wsacc.org
This is a notice of capacity for the flow acceptance request received by the Water and Sewer Authority of Cabarrus
County (WSACC) from the City of Kannapolis on October 2, 2019. WSACC has or will have capacity at the
Rocky River Regional Wastewater Treatment Plant and appropriate sewer interceptors to transport and treat the
commercial wastewater from the proposed project entitled Grace Manor Private Sanitary Sewer .Extension, located
on Kannapolis Parkway. The referenced project will serve wedding venue with 594 seats, with a projected
wastewater flow of 17,820 gallons per day (gpd). The wastewater generated by this project will be conveyed
through a proposed force main, through the existing gravity system, and then enter WSACC's system at the existing
42-inch Jrish Buffalo Creek interceptor, WSACC acknowledges it has or will have capacity for wastewater from
the proposed development based on information provided by Darden Engineering Services, PLLC (Civil Engineer
for the project) using North Carolina Department of Environmental Quality (NCDEQ) wastewater flow guidelines.
The WSACC Capital improvement Program (CIP) has been on pay as you go since Fiscal Year 2005 — 2006,
funding Capital Projects entirely from Capital Reserves, and WSACC expects to continue this policy into the
future.. Projects on the CIP are subject to approval by WSACC's Board of Directors, support from local governing
bodies, regulatory approval, and funding availability. The list and schedule of OP projects are tentative and are
revised periodically to reflect changing conditions and needs,
If construction of this project does not commence within two (2) years of the date of this notice, the notice is
rescinded and a second request and notice will be required before flow capacity is accepted. Please notify
WSACC, in writing, when construction of this project is initiated. This sewer capacity allocation may also he
cancelled pursuant to the conditions set forth in the WSACC Sewer Allocation and Commitment. Policy.
Please note that the final commitment to service toprovide wastewater treatment services shall occur upon
application for a building permit for the project and when system development fees are paid pursuant to
§162A, Article 8.
If you have any questions, please
[phone], extension 104.
Sincerely,
. Thomas Hahn, PE
Utility Systems Engineer
cc: Misty Tutt, PE/Kannapolis
Wilmer Meiton/Kannapolis
John C. Darden, 111, PE/Darden Engineering Services, PLLC
Michael Wilson/WSACC
Chad VonCannon, PE/WSACC
Mark Lomax/WSACC
Trent Gobble/WSACC

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTsE -ion 8)
(WSACC USE ONLY) Grace Manor Private Sanitary Sewer Extension
Section 1. Name of wastewater treatment facility (WWTF) receiving wastewater:
Rocky River Wastewater Treatment Facility Permit 4INC0036269
Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
facility's psrmitted flow, MGD 26,500
Estimated obligated flow not yet tributary to the WWTP 2.802
WWTP facility's actual avg, daily flow, MGD 20.07 (75.74% of permit)
Total flow for this spific request., MGD 0.018
Total actual and obligated flows to the facility, TAGD
Percent of permitted flow used
22.890
86.3 8%
Section II. Pump stations along the route from the Jurisdiction's connection. point to the 1,\IWTP..
Tr(A)
Pump Station ,omp zrlation , . Firm Design Average Appros. Curicid
(Name or ,patly "' Daily Flow " Average Daily
"mitt No.
Number) MCD (Firinipf) Flow
MGD 1 111(3)
NC0036269 55.440 22.176 '1.1.945
.R.R.R.WWTP
MPS
(C)
igmed, Nut Yet
Tritanary Daily Flow
MGD
(D) - (8+C) (E)--(A..D)
'Total Current How Available
Plus Obligated Flow
MCI) MGD
r2.534
9 642
1
The Porto Capacity (design flow) of any pump station is defined AS the maximum pumped flow that can tie schiesed with the largest pump taken out of service.
"Design Average Daily How is the firm capacity of the pump station divided by a peaking factor (pf) not Less than 2.5, per Section 2.01(A)(4)4c) of the
Design Criteria.
Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the NVWTP where Available
Capacity is:5_ Cl.
Section III, WSACC Certification Statement:
1, J. Thomas Hahn,. PE, certify to the best of my knowledge that the addition of the volutne of wastewater to be permitted
1n this project has been evaluated along the route from the connection to the WSACC interceptor to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity related sanitary.
sewer overflows or overburden any downstream. pump station en route to the receiving treatment plant under normal
circumstances, given the implementation of the planned improvements identified in the planning assessment where
applicable. This analysis has been performed in accordance with local established 'policies and procedures using the best
available data, This certification applies to those items listed above in Section 1 and Section II plus all attached 'planning
assessment addendurns for which 1 ant the responsible party. Signature of this form indicates WSACC's guarantee of
capacity for this wastewater flow, Notwithstanding the guarantee of capacity, 'WSACC does not make a commitment to.
service this wastewater flow until a building permit is requested through the Cabarrus County Building fnspections
Department and WSACC rceives payment of the System Development Fee.
:7's Signing Official Signature
Ji

CERTI FICAT IONS:
1. Does the submitted system comply with 15A l'1CAC 02 1 the Minimum Ocsigit Criteria for the Permitting, ot i'unap,Statitins
N43111,5„0„XestAS:r5,11,111 and the Qr31, 11..L5v1TLM11-timp.tafi?Ptvii,,:xitgriilkittig.51aZera:10) 3,5 applicable?
0 No
r No, complete and submit the Variance/Alternative Design Request application (VA DC 10-14) and supporting documents for
review AvpLuval of tlae request is, required KKK o submittal of the Fast Track Alvticatian and sunnortiagtjocum.ems
2. Professional Engineer's Certification:
JOhr: Da. rden P. ./7., attes that this application for
(Professional .Engineer's name from Application Item 1E1.1;1
has been reviewed by me and is accurate. complete and consistent with the in formation supplied in the plans. specifications,
engineering calculations, and all other supporthig documentation to the hest of illy knowledge. 1 further attest that to the best
of nr knowledge the proposed design has been prepared in accordance with the applicable regulations. Gravity Sewer
Minimum Design Criteria for Ciravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
'have judged it to be consistent with the proposed design.
NOTE — In accordance %vitt) General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, represemanon, or certification in no application package shall he ,guilty of a Class 2 'misdemeanor, which may
include a tine not to exceed $10.000, as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature. and date:
3. Applicants 2ertitication per 1,5A NCAC 02T tot:, :
1, _ S 5 e- attest that this application for
(Signature Authority's name tit e from Application Item 1,3.)
has been reviewed by me and is accurate and a ,mplete to the best of my knowledge, I understand that if all required parts of
this application are not completed and that :f '-'11 required supporting documentation and attachments are not included, this
application package is subject to being returneeas inconiplete 1 understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief. and:or criminal prosecution_ I will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all required supporting information and artact ments are not included, this ;application package wil1 he returned to the as
incomplete,
NOTE — In accordance with General Statute 14 „. ,6A and 1,4121,5,6,R, any person who knowingly makes any false
statement, representation, or certification in at y application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S10,000 as well as is il penalties up to S25,000 per violation.
Date:
FOR Ni: ETA 04-16
Page 5 of:5

STREET LEVEL MAP
C ()cation of Proposed Sewer Extension
Connect private
FM to pubBic
sewer extension
Googl+
20 a Googi ?
rid
3425 Kannapolis P
1000 ft

0

North Carolina Secretary ()IState Search RasaIts
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Limited Liability Company
Legal,. Name
Rosser tioldinds, LUC
orrnation
SOsid: 1632190
Status: Current Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 10/19/2017
Registered Agent: Rosser, Robert L Jr
lage 1dial
ddresses
Reg Office
6100 MooresvRe Rd
Kannapolis, NO 28081
Principal Office
6100 Mooresville Road
Kannapolls, NO 28081
pany fficials
Reg Mailing
61 DO Mooresville Rd
Kannapolis, NC 28081
Malting
6100 Mooresville Road
Kannapoils, NO 28081
Ail LtiCs are managed by their managers pursuant to N.C,G.S 57D-3-20
President
Robert Rosser
6100 Mooresville Rd
Kannapolis NC 28081
IZ.ostilts• 1.1191:201 9

Page 1 of 1
November 14, 2019
Re: 3425 Kannapolis Parkway
Kannapolis, NC
The following is a submittal for a private pump station and force main installation servicing a wedding venue with a
design flow rate of 17,820 GPD. The 2" line will run 443 feet from the on site pump station and tie into the
proposed public gravity sewer submitted under separate permit along. Kannapolis Parkway.
Sincerely,
John C. Darden III, PE
Darden Engineering Services, PLLC
Firrn License #P-1663